부산대학교 도서관

Aim and objectives: The aim of this thesis is to explore how outcomes are measured for adults with ankle fracture, and to assess whether they are appropriate, within the context of randomised controlled trials. To achieve this aim the following objectives were met using a variety of research methods. These were systematic reviews in chapters 2 and 3; qualitative methods to explore the construct of interest in the population and the content validity of the Olerud Molander Ankle Score in chapters 4-5 and finally secondary analysis of clinical trial data to determine the validity, reliability, responsiveness and interpretability of the Olerud Molander Ankle Score in chapter 6. Key findings: Key findings from this programme of research demonstrated that there is a wide range of outcome measures collected in RCTs for adults with ankle fracture. Patient reported outcome measures were the most commonly used, but a further systematic review highlighted that these measures had insufficient measurement properties. The qualitative work showed that individuals experience a broad range of issues following ankle fracture, including reduced mobility, issues adhering to weight-bearing restrictions, loss of independence, sleep problems and impacts on psychological wellbeing. Some participants didn't feel the Olerud Molander Ankle Score was a relevant and comprehensive reflection of their recovery and some had issues with the response options. Results of quantitative analysis showed an underlying structure of two subscales within the score, sufficient convergent validity, responsiveness, internal consistency and no edge effects. Conclusions: The Olerud Molander Ankle Score is likely measuring the construct of patient reported ankle function, rather than a holistic representation of the multifactorial concept of recovery from ankle fracture. It may be that this is appropriate for some research questions, but not all, dependent upon the construct of interest for the specific research question.